So, today I had GW removal by hyrefecation and my first shot of the HPV vaccine.
3 GW’s … shaft, scrotum and one on the base. Looks like I have tiny skin tags too on my scrotum, Which have previously been mistaken for GW’s by NHS and a private derm.
What i was told by NHS was a GW on the frenulum, is apparently just part of my circumcision scar. The doctor was 100% confident of this and offered to do a skin swab to confirm, but it would cost another £200. She didn’t want to biopsy as she said she was certain it wasn’t GW.
The procedure ….

1. Thorough Examination of suspected GW and genitals
2. Apply numbing cream. 15 minutes later, apply more numbing cream. This really works. It felt like I was getting random semi at first 🙈 but then it was very numb from tip to base
3. Try small patch of hyrefecation to test for pain. I had pain, so had to have 5 injections into each site … shaft, scrotum and base. I didn’t watch this and can’t confirm why it was 5 injections and only 3 sites. I just know it was 5. It actually wasn’t as bad as I thought it would be! Possibly less painful than cryotherapy.
4. Hyrefecation … it’s like a little pen with a loop at one end that removes and cauterises the GW. I didn’t feel much at all.

The procedure was done 7 hours ago, and I’m still numb down there. Looking at it, the GW’s are gone and a blister has started to form. It looks like a tiny little scab too.
Important note!!! This doctor specialises in sexual health dermatology. She is one of the leading UK specialist who use hyrefecation. Her advice is to GET THE VACCINE!! It will protect from future strains and will possibly help with existing HPV infections by creating antibodies. There is also another treatment which I can’t remember the name of. It ends with “air” and is a course of tablets taken over a period of months. Forgot the name sorry! Will find out and update the post.
This was the clinic Clarewell Clinics — #1 Voted Private Sexual Health Clinic UK
This is the best experience I’ve had for treating HPV / genital warts. The UK / NHS is just useless when it comes to HPV treatment, in my experience at least.
If you’re in the UK, I would highly recommend going private with a specialist. The NHS treat it like it’s not an issue, but it’s a huge issue for most people and the psychological impact is devastating for many, such as myself.
For reference, Today cost £600 for removal and one shot of Gardasil 9. That’s a lot of money!!! But I’m 99% sure I’m wart free after one session. It’s just the ones that the doctor said are my circumcision scar that worry me a little. She convinced me 99%, but there’s that tiny nagging doubt.
I know they might come back, but I’m just glad I’m being proactive and doing what I can 🤷🏻‍♂️
Hopefully this post helps others 🙂

Hi all,
Posting here because I'm about to lose it. Long story short, a week ago, my cat got spayed. During that time, I've had a hell of a week with her. She's been so, so hard to take care of. We have a spare room in the house my roommate and I share, which doesn't have furniture, so I kitted it out for her spay procedure.
Should've been fine right? No! She hated being in there alone. The first night, as soon as she got home, she turned into a tasmanian devil. There's a gap between the floor and the door to the room, so quite literally ALL NIGHT her paws were under there, trying to pull open the door, trying to shove her face through it to escape (so much so she rubbed fur off of her forehead), and yowling. She didn't sleep at all. I got maybe 2-3 hours of sleep tops.
That was a week ago, and I've had varrying degrees of success with Gabapentin for her to calm her down. We've been keeping her in this spare room the entire time. She was very calm days 1-4 for the most part (unless she was coming off of Gabapentin), but as soon as day 5 hit, she decides "okay, I'm normal now, please let me out" and starts trying to play, jump, pounce, jump at the door handle to get out, etc.
Her incision looks okay, not the prettiest, but not swollen, not open, not leaking, not bleeding despite all of this. I called the place that spayed her today (low-cost spay/neuter clinic) and they told me she's okay to re-enter the household and just to watch her when possible, cats will be cats.
Okay great, thank fucking god. Letting her out should calm her. Nope, not at all. She's again going absolutely fucking ballistic just throughout the house this time. Jumping up to places she never had interest in before, running around constantly, just full-on constant zoomies and bad girl behavior.
Has anyone experienced this before? Do they have any tips? I can't keep going on like this with her, she's driving me insane. I took off from Thursday Tuesday hoping that would be enough to watch her and have her heal but I've been at work the last few days and I'm now worried sick about my cat running around the house causing all sorts of ruckus.
We also have another cat who's a sweetheat, and they love to play, but they can play kind of rough, so I'm suggesting to my roommate to keep them separate until her incision looks bette14 days comes up.
Again, ANY advice would be appreciated. Thank you so much.

Hi all, fairly new to Reddit, so please let me know if this is the right place to post. Warning- pretty long.
I was diagnosed with MS in 2012 when I was 38. I had weird vision issues, it felt like one eye wasn’t coordinating with the other. I could look at my classroom and see the students, but their faces were blurry. I couldn’t drive at night because of light tracers. Went through the normal ophthalmology channels and was referred to a neurologic ophthalmologist. He did a MRI just to be safe because there were no signs of optic neuritis. After my very first MRI, the nurse asked if this was my first, and said the doctor would call me the next day. I told her my doctor was leaving for a month and he said he’d follow up with me when he got back. The nurse said no, he would call me the next day. Surprise! You have MS and aren’t having acid flashbacks from the one time you took it at age 18.
Luckily, I was living in an amazing state with an impressive University medical center. My neurologist taught at the U and going to an appointment was like attending a class. He whipped out a sharpie and starting making amazing flow charts on the paper covering the exam table. He gave it to me at the end. Since the MRI showed active lesions, I took a super high dose of steroids. In the following 5 years, MRIs showed no new lesions, so I never started any medication. My brain developed new pathways and my vision cleared up.
In 2017, I decided to move home to Montana. After the fun experience of establishing care, I was given an absolutely wonderful neurologist in my large and growing city. He wasn’t an MS specialist, but there are only 2 in our state. At this point, I didn’t think I had MS since no new lesions in 5 years. So, I got an MRI here, and low and behold, new lesions. (Part of the reason is the MRI machine here is newer with better quality.) I was started on Copaxone. About 4 months after starting, I had a relapse and lost some mild functioning in my left hand. In addition, I started having problems with my vision again- same issue as before. Had a follow up MRI showing no new lesions. I was also under a ton of stress during that time. I’ve now figured out that when I get stressed, my brain “forgets” the new neural pathway and reverts to the old broken pathway.
So, I was struggling with high stress from my job and extreme exhaustion. He sent me for a sleep study and I was diagnosed with apnea and started using a C-Pap. No change on the exhaustion. They started me on Modafinil and it was a game changer. Over the next 2 years, I lost a significant amount of weight (in a healthy way). My next sleep study showed no apnea at all (yay!) but my oxygen levels dropped significantly when I slept. So now, I’m on oxygen when I sleep. My sleep doctor did some blood tests that showed my iron levels were low but my ferritin test was high, so I couldn’t take any supplements.
Then, my neurologist, who I absolutely adore, explained that the entire neurology department (doctors only) quit due to the horrible administration. I had access to a PA over the next year. Just to be clear, there are two MS specialists in my state- the one 2 hours away was not accepting any new patients and the one 3 hours away had a 2 year wait. I live in the fastest growing city in the US, and it’s a college town. The hospital here is very large and serves all the rural communities. Luckily, a new health clinic extension is opening and I’m hoping the competition will bring positive changes. But, new clinic won’t have a neurologist for at least another year.
In the meantime, my cognitive and executive functioning have fallen off of a cliff. My short term memory is the same as a goldfish. My exhaustion is at an all time high and Modafinil assistance has plateaued. I quit my job and now am doing private tutoring- but I can usually only handle 4 hours a day. I can still tutor because I have been doing the same program for over 20 years, but learning something new is almost impossible. Perfect example of executive functioning issues: I went over to help a friend learn how to can and make jam. No problem! Then I go to pack up my stuff and I can’t figure out how to do it. It usually takes me 3 or 4 tries to leave the house, even if I have tried to set out what I need the night before. I have a waitlist of private clients needing help, but I’ve become so flaky with cancelling sessions because I never know when I will hit a brick wall, so I don’t want to start with any new clients.
Then, I get a call scheduling me with a new neurologist to establish care. Yay!!! And I find out that he is a neurology generalist, and of course, 1 neurologist to cover a large population. I like the new neurologist, but can tell he was stressed and overworked. I had the hard conversation about going on a partial disability. I am also having some cardiac issues that also cause fatigue. And surprise- here is another lesion that they missed on my last MRI a year ago. I asked how to start the disability process, and the doctor said the hospital used to have a social worker to help but not any more.
Now, I’m scheduled for a follow up MRI and neuropsych evaluation. I had to have an internal heart monitor installed. A new cardiologist ordered genetic testing, and that came back with an “unknown marker”. I’m also having problems with my joints hurting and popping out of place (this is also congenital- my joints dislocate super easy). I am depressed over not being able to afford to live. I am overwhelmed with trying to figure out public assistance here. The local Human Rights non profit has helped me apply for SNAP and emergency rental assistance, and I found someone at our low income clinic to help with disability paperwork today, but she said I will be denied and it will be a long process.
I can’t do the paperwork on my own. I did find a counselor and have an appointment next week. I feel like I am drowning and am grieving losing my independence. The worst part is that my MS is invisible. I have no lesions on my spine, and one optic nerve is slightly larger than the other, but healed. My left hand is a little slow, but only I notice. I grew up in a family (and state culture!) that you pull yourself up by your bootstraps and don’t ask for help. People can’t see that I’m struggling. I’ve been accused of being high when I repeat a conversation or have a hard time coming up with a word. My fabulous brother accused me of making it all up to be a “freeloader” that is too lazy to work. There are no MS support groups here. Parkinson’s & Huntington’s have multiple groups. Even attending an MS group is difficult because I don’t have mobility problems and I don’t feel welcome.
Any helpful advice? (After the new MRI, we will revisit changing from Copaxone to another medication.)

What goes up must come down... unless you have diamond hands. Some cracks are beginning to appear in the recent AI stock rally, with C3.ai (AI) plunging 22% AH on Wednesday after giving a disappointing outlook during its FQ4 results. On an earnings call, CEO Tom Siebel added that the company wasn't "inclined to change expectations" surrounding its guidance, compared to the major boost that Nvidia's (NVDA) stock received following its "jaw-dropping guidance" posted last week.
Snapshot: Other AI players and chipmakers also pulled back yesterday following some impressive runups, but the latest movement might suggest that all companies are not equal when it comes to the "AI supercycle." Investors will have some deep learning to do after being consumed by everything AI this year, especially as they sort through the growing list of companies talking up how they've been AI plays all along. The real thing to consider is how much a firm will successfully capitalize and monetize its artificial intelligence offerings after the meme rallies settle down and huge price swings come to a halt.
"The euphoria is rooted in a very promising underlying technology," noted Robert Schein of Blanke Schein Wealth Management. "Even with the recent market euphoria driven by artificial intelligence, the market is sending a clear signal that artificial intelligence is here to stay, as this technology has the potential to overhaul how companies do business, which has major implications for corporate earnings."
Do your homework: As an example, the overwhelming majority of Wall Street experts believe that Nvidia (NVDA) remains a clear Buy. Seeking Alpha's Quant Ratings system views NVDA with a little more skepticism, labeling the stock as a Hold (valuation represents the key headwind, according to the system of grading quantitative measures). SA analysts have also been sizing up the stock in a series of recent articles. See 11 Billion Reasons To Buy Nvidia, And 2.2 Trillion Reasons To Sell, Bulls Are Way Overestimating AI GPU Demand and Unleashing The Power Of Parallel Computing For AI Dominance.
Fiscal Responsibility Act
The U.S. House last night easily passed the debt-ceiling relief deal as the Treasury heads toward a June 5 deadline, after which the government won't have ready funding to pay its bills. The measure now goes to a Senate also working under a tight timetable and preparing for weekend votes. A number of senators have already expressed the wish to amend the bill, meaning it could return to the House for more approval, but the process is expected to get over the finish line in time. With much of the drama in the rear-view mirror, investors have once again set their sights on central bank policymaking, with Fed officials like Patrick Harker and Philip Jefferson calling for a pause this month and assessing the need for future rate hikes thereafter. (104 comments)
Publisher compensation
Meta Platforms (NASDAQ:META) is threatening to pull news links from Facebook and Instagram in California if state lawmakers move forward with the "California Journalism Preservation Act." The company responded in a similar fashion after a related proposal was tabled in Congress in December, as well as in Canada, and briefly blocked news links in Australia before brokering a deal with the government there. Among the amendments was a clause stipulating that digital platforms and news groups would be required to mediate for two months before subjecting them to mandatory arbitration. Canberra also agreed to take into account existing commercial agreements and give digital platforms a month's notice before reaching any final decision on the law's application. Will the same happen again? (4 comments)
Doom and gloom update
While attention has been centered on the remote, but disastrous possibility, of the U.S. defaulting on its debt, investors may want to focus more on corporate bonds. Preparation is underway for a wave of defaults in the high-yield credit markets as the boom-and-bust cycle returns in 2023. Deutsche Bank issued its 25th annual Default Report and sees the default rate on U.S. junk debt spiking to a peak of 9% of issuance by the end of 2024 vs. 1.3% in 2022. See how that compares to other cycle highs like the dot-com crash and the Great Financial Crisis. (47 comments)
Today's Markets
In Asia, Japan +0.8%. Hong Kong -0.1%. China flat. India -0.3%. In Europe, at midday, London +0.5%. Paris +0.8%. Frankfurt +1.1%. Futures at 6:30, Dow +0.1%. S&P +0.2%. Nasdaq +0.1%. Crude -0.2% to $68.22. Gold -0.4% to $1974.40. Bitcoin -0.7% to $26,946. Ten-year Treasury Yield +4 bps to 3.68%
Today's Economic Calendar
7:30 Challenger Job-Cut Report 8:15 ADP Jobs Report 8:30 Initial Jobless Claims 8:30 Productivity and Costs 9:45 PMI Manufacturing Index 10:00 ISM Manufacturing Index 10:00 Construction Spending 10:30 EIA Natural Gas Inventory 11:00 EIA Petroleum Inventories 1:00 PM Fed's Harker Speech 4:30 PM Fed Balance Sheet
Companies reporting earnings today »
What else is happening...
Has 'greedflation' caused corporate profits to increase?
Job openings unexpectedly rise in April, quits rate ticks down
Exxon (XOM), Chevron (CVX) shareholders reject climate proposals.
U.S. crude oil slumps to 10-week low, down 11% for May.
Pfizer's (PFE) RSV vaccine, Abrysvo, gets a nod from the FDA.
Retail watch: Nordstrom (JWN) gains on unexpected Q1 profit.
Salesforces (CRM) sinks after earnings; so does CrowdStrike (CRWD).
Amazon (AMZN) settles kids' privacy case and Ring spy claims.
Lucid (LCID) to receive $3B from new investors, including Saudi Arabia.
Ford (F) CEO says EV price parity is unlikely until after 2030.

The bladder is a hollow, muscular, balloon-shaped organ found in the pelvic region. It holds urine produced by the kidneys until it exits the body through the urethra. The malignant growths/ tumors in the tissues of the urinary bladder are referred to as bladder cancer.
Bladder cancer that starts in cells of the bladder's inner lining is the most prevalent form (transitional cell carcinoma). Squamous cell carcinoma, which starts in the thin, flat cells lining the inside of the bladder, and adenocarcinoma, which starts in the cells that secrete mucus, are the other forms.
In India, bladder cancer therapy is available at a very low cost, with high quality medical facilities and excellent outcomes. India has recently been a popular medical tourism destination for patients from all over the world seeking treatment from world renowned doctors in India's highly accredited facilities.
Also, in India, bladder cancer therapy is accessible on a very fair and inexpensive basis. Because of its great medical facilities, India has become one of the most popular tourist destinations in the world. The cost of bladder cancer treatment varies based on the approach employed. A wide range of therapy alternatives are accessible in India. The cost of bladder cancer treatment in India is also influenced by factors such as the hospital chosen, the specialists engaged, and the doctor's expertise.
https://medserg.com/treatment/bladder-cancer-treatment/

Symptoms Of Bladder Cancer

Haematuria (blood in the urine) is the most prevalent symptom and usually the first indicator of malignancy. It is usually painless and depending on the amount of blood in the urine, the urine may appear pale pink, brown, or crimson (occasionally). The blood may not be visible at times, and the urine may appear to be clear, but urinalysis may reveal minute amounts of blood (urine test). It is also possible that the blood will vanish for weeks after the initial sighting.
Urinary pattern changes include frequent urination (more than normal), burning or irritation during peeing, and unexpected desires to urinate even when the bladder is not full. These are the symptoms of bladder cancer in its early stages, and they may overlap with those of other illnesses such as urinary tract infection, bladder stones, kidney stones, or an enlarged prostate in men. In any situation, a visit to the doctor for a check-up is required.
Advanced stage symptoms include:

• Pelvic discomfort
• Inability to urinate
• Inflammation of the feet
• Bone ache
• Weight reduction that occurs unintentionally

What Are Some Bladder Cancer Risk Factors?

A person's risk of acquiring bladder cancer is increased by a few variables.

• Age: As you get older, your chances of developing bladder cancer increase. Approximately 90% of those diagnosed are above the age of 55.
• Smoking: Smoking is one of the most significant risk factors. Smokers are at least four times more likely than non-smokers to develop bladder cancer. Tobacco includes carcinogenic agents (cancer-causing substances) and is the cause of half of all bladder cancers.
• Men are three to four times as likely than women to have bladder cancer.
• Drinking water containing arsenic has also been related to an increased risk of bladder cancer. The likelihood of being exposed to arsenic is determined by where you live and the source of your drinking water.
• The second leading cause of blood cancer is exposure to specific chemicals. Bladder cancer is increased by some industrial chemicals used in the dyeing, textile, paint, leather tanning, and printing industries. Bladder cancer has also been related to some naturally occurring compounds, aromatic amines, and herbal products including aristolochic acid.
• People who have had a family member diagnosed with bladder cancer are more likely to develop the disease themselves. Changes in genes such as GST and NAT, which are involved in the breakdown of some toxins, have also been linked to an increased risk of bladder cancer.
• Long-term urinary tract infections (UTIs), kidney and bladder stones, and using bladder catheters for a long time have all been associated to the development of chronic bladder infection.
• Chemotherapy and radiotherapy-induced secondary disease: Long-term treatment with chemotherapy medicines might irritate the bladder. Bladder cancer is more likely in people who have been treated with this medicine.
• People who are exposed to radiation near the pelvic region during cancer treatment, such as bowel cancer, are more likely to develop bladder cancer.
• Schistosomiasis, which is caused by a parasitic worm going into the bladder and is mostly found in Africa and the Middle East, is also a risk factor.

Bladder Cancer Treatment Cost In India

• Chemotherapy: Starting USD 270 per session (Indian Rupees Approx. 19,000)
• Surgery: Starting USD 2700 (Indian Rupees Approx. 1,90,000)
• Radiation Therapy: Starting USD 3,100 (Indian Rupees Approx. 2,20,000)
• Trans-Urethral Bladder Tumour Resection (TURBT): Starting USD 3,600 (Indian Rupees Approx. 2,50,000)

Diagnosis Of Bladder Cancer

The distinct indications of bladder cancer in the urine and bladder are investigated using a variety of assays and techniques. The following are examples of diagnostic assessments:

• Urinalysis is a simple test that looks for blood and other chemicals in a urine sample. This test employs chemical dipsticks that change colour in the presence of chemicals such as glucose, red blood cells (RBCs), and so on.
• Urine cytology is the study of a urine sample under a microscope to look for pre-cancerous or malignant cells. For this procedure, the urologist inserts a cystoscope into the opening of the urethra and into the bladder to examine the inner lining of the organ. A camera and a lens are linked to a narrow tube, it is what is called a cystoscope. To make the procedure comfortable and soothing, the patient is usually given a local anaesthetic cream to apply to the urethra.
• Biopsy: If abnormalities are discovered during a cystoscopy, the patient will be given a biopsy operation termed "Transurethral Resection" of a bladder tumour (TURBT). The tumour (abnormal region) must be removed, and the area must subsequently be tested for malignancy. Because cancer often spreads to multiple areas, multiple samples are taken for testing to see if the cancer has migrated to surrounding bladder muscles.
• Imaging Scans: For a more exact image of the bladder, these scans allow the specialist to determine whether cancer has progressed to tissues near the bladder, urinary tract, neighbouring lymph nodes, or other organs. Imaging tests include the following:
• A dye is used in an X-ray treatment to show the kidneys, ureters, and bladder, as well as malignancies in the urinary tract. IVP (intravenous pyelogram):
  • Scanning using a CT scanner
  • Ultrasonics
  • The magnetic resonance imaging (MRI)
  • Scanning of the Bone (to check for spread to the bone)

India's Bladder Cancer Treatment Options

Many treatment options for bladder cancer are accessible in India, depending on the point, and other criteria such as patient health and preferences are available.
Surgical removal of cancer cells and accompanying tissues is referred to as surgery. Various types of surgery are offered depending on the stage and extent of cancer. Surgical options for bladder cancer include:

• Trans-Urethral Bladder Tumour Resection (TURBT): This procedure is used to treat and diagnose bladder tumours. During this procedure, a cystoscope (a small tube with a light and a camera) is introduced into the bladder through the urethra. A small wire loop is attached to the end of the cystoscope and is used to remove abnormal tissues or burn the tumour with a laser or high-energy electricity (fulguration). The patient is given local anaesthetic for TURBT. In the early stages of non-muscle invasive bladder cancer, this is the most usual treatment option.
• Cystectomy: The bladder is removed entirely or in part. When there is invasive cancer, this procedure is used.
• Radical Cystectomy entails the removal of the whole bladder as well as surrounding lymph nodes. When cancer has invaded the muscle walls and is large, this surgery is used. The prostate and seminal vesicles are the adjacent organs removed in males with this procedure. The uterus, fallopian tubes, ovaries, and a portion of the vagina are among the organs removed in women. The surgeon then creates a new path for the body's urine to flow through.
• A segmental cystectomy is also known as a partial cystectomy. Only a part of the bladder is removed, together with the area of the muscle layer that has been invaded by cancer. The most significant benefit of this operation is that the patient retains his or her bladder and can urinate regularly following recovery.
• Urinary Diversion: Reconstructive surgery is used to develop an alternative method of storing and transporting pee. Various types of surgeries may be performed depending on the medical situation and the patient's preference. The three types are as follows:
• Incontinent Diversion: The surgeon removes a section of the intestine and connects it to the ureters to create a conduit for urine to exit the body. As a result, urine flows from the stoma, a hole in the skin in front of the belly, through this passageway from the kidneys to the outside world. The urine comes out in little amounts and is collected in a small bag placed over the stoma. In this process, there is no control over the flow of urine.
• Continent Diversion: A portion of the small or large intestine is utilised to produce a pouch that serves as a urinary reservoir within the body, with one end of the pouch attached to the stoma. A valve is created in the pouch, allowing urine to be stored. This method appeals to the patient because it eliminates the necessity for an external bag. Urine can be evacuated from the stoma with the use of a catheter.
• Neobladder: This is a new procedure in which the surgeon creates a new bladder (Neobladder) from a section of the intestine and connects it to the urethra. This method restores urination by rerouting urine back into the urethra. As a result, the patient will usually pass pee.

Chemotherapy is a treatment that uses medications to destroy cancer cells by preventing them from dividing and expanding. The technique can be done at the same time with a single anticancer agent or a combination of treatments (combination drug). Chemotherapy for bladder cancer involves 2 types:

• Intravesical Chemotherapy: This method is used to treat cancer in its early stages and involves injecting a chemotherapeutic agent directly into the bladder.
• Systemic Chemotherapy: For this treatment, the drugs are given as tablets or injected into a vein or muscle, where they enter the bloodstream and disseminate throughout the body.
• Radiation Therapy: This entails the use of high-energy x-rays to halt and destroy the growth of cancer cells. There are two types of radiotherapy:
• External Beam Radiation: This is the most popular type of radiation therapy, in which a system located outside the body is used to guide radiation directly to the tumour.
• Internal-Beam Radiation/Brachytherapy: This treatment uses radioactive implants, such as needles, seeds, or catheters, that can be put close or directly into the malignancy. Radiation therapy is typically used after surgery (TURBT) to kill any remaining cancer cells, as part of advanced-stage cancer pre-treatment, or to relieve symptoms like pain and bleeding caused by advanced bladder cancer.
• Biological therapy is also known as immunotherapy. This treatment is the administration of medicine to boost a person's immune system, allowing them to detect and battle cancer cells. It is necessary to employ compounds made by the body or in a laboratory to strengthen or target the immune system or restore function. The BCG vaccine is an example of biological agents used in immunotherapy after TURBT treatment. Other drugs utilised include atezolizumab, avelumab, and nivolumab. The drugs are given as intravenous (IV) infusions every 2 to 3 weeks.

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https://reddit.com/link/13xamgt/video/ga4wy15bnc3b1/player
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Animal testing is absolutely necessary for advancing biotech, I've concluded. When the right time, right circumstance, and right money come, I will do laboratory animal testing for advancing medical biotech, human longevity biotech, human genetic engineering biotech, human body manufacturing and replacement biotech, human fertility duration lengthening biotech, and other types of biotechnologies. I've a multidecadal commitment to advancing biotech for enabling long-lasting human life and youth, longer human fertility duration, and better human health for everyone.
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Doing laboratory animal testing in the U.S. requires adhering to the U.S. federal, state, and local regulations. Boston in Massachusettes, and San Franciso in California, in particular, perform the most numbers of animal tests in the U.S., for advancing biomedicine and biotech.
The Animal Welfare Act is the U.S. federal law that regulates testing on certain types of animals.
According to my calculation, maintaining an Animal Welfare Act compliant animal testing facility in the U.S. requires at least a multiple six-figure U.S. dollars annual overhead or biotech research expense, and most likely over one-million U.S. dollars annual biotech research overhead; as such, it is not cheap.
Because my aim is building a variety of biotech businesses at Robocentric, with multiple biotech product lines, I don't have to have an Animal Welfare Act compliant animal testing facility in the U.S. to launch the first Robocentric biotech products. As such, I'll first establish and operate an animal testing facility in the U.S. that isn't applicable to the Animal Welfare Act, a non-Animal Welfare Act applicable animal testing facility in the U.S., which will be much cheaper than operating an Animal Welfare Act compliant animal testing facility in the U.S., and have very low overhead.
Robocentric will get into a variety of biotech businesses—namely research and medical biotech devices development and manufacturing, medicinal biotech, cosmetic biotech, supplement biotech, and industrial and consumer biomatter design and manufacturing biotech.
For a lot of the biotech products that Robocentric will develop and market, an Animal Welfare Act compliant animal testing facility won't be absolutely required, and a non-Animal Welfare Act applicable animal testing facility will do, although eventually Robocentric will need one or more Animal Welfare Act compliant animal testing facilities—perhaps in Boston, San Francisco, or both and maybe in other locations—for pushing biotech development and commercialization to the uttermost extremes.
Robocentric will do nonhuman animals genetic engineering experiments, documentation, and publication for advancing medical biotech for curing human genetic diseases by replacing disease-causing human genes with healthy human genes.
Robocentric will do fully robotized genetically engineered nonhuman animal care in confinement for the experiments, 3D scanning, and results publication.
Robocentric will write and publish "Robocentric biotech development plan for nonhuman animals genetic engineering experiments, documentation, and publication for advancing medical biotech for curing human genetic diseases by replacing disease-causing human genes with healthy genes".
Robocentric will do genetic engineering experiments especially on nonhuman primates, for creating improved nonhuman primates with faster reproduction cycles, and for creating human genetic disease cures.
Robocentric will write and publish "Robocentric biotech development protocols and processes for breeding and performing experiments on nonhuman primates for developing medical biotech with regulations to abide by".
Robocentric will do age acceleration and deceleration, anti-aging, and deaging biotech development experiments on nonhuman primates such as on chimps for medical research including cancer cure research, human longevity biotech development, and nonhuman-animal and human aging control biotech development.
Robocentric biotech research nonhuman animal breeding and nursery facility in the U.S. will have maximum robotization with less than US$250,000 per year upkeep cost, with all animals in triple confinement (three layers of walls and doors), in comfortably large spaces, with robot-only access in animal confinements for cleaning, feeding, and animal wastes removal.
Robocentric will develop and commercialize chimpanzee genetic engineering biotech, growth hormone biotech, and neurotech—for enabling chimpanzee growth accelerator (for enabling reaching sexual maturity in less than a year), and breeding accelerator (for enabling reproducing every year or less), for much faster biomedical research.
Robocentric will build and maintain its biotech research nonhuman animal breeding and nursery facility or facilities in the U.S., starting at the most appropriate time.
Robocentric will do human fertility duration lengthening biotech R&D (especially for women), which will require nonhuman animal testing, on both non-primates and primates.
Robocentric will do human blindness and deafness cure research, including medical human genetic engineering biotech research. More than 350 eye diseases are attributed to hereditary factors.
Robocentric will do animal testing because research lab animals will provide valuable biological insights for curing the human body diseases, disabilities, damages, and conditions.
At Robocentric Biotech, we'll treat our research lab animals with dignity, respect, and humane care.
Robocentric will specify in writing and publish how and why research lab animals are used at Robocentric Biotech research facility—for curing human body diseases and disabilities and damages, for developing human longevity biotech, for developing human fertility duration lengthening biotech, for curing human-food animal diseases, for biotech research data measurement, documentation, and publication.
The types of research lab animals used at Robocentric Biotech research facility will be rodents, farm animals, nonhuman primates including chimps, and more.
For developing and commercializing aging control and human fertility duration lengthening biotechnologies, Robocentric will research creating genetically engineered chimpanzees and bonobos with fast growth and sexual maturity, and shorter reproduction cycle.
I will author and publish "Robocentric biotech development sequence and research lab animals breeding, nurturing, and usage plan", which will include the following.
First, rodent, human-food animal, and nonhuman primates whole-body microscopic 3D scanning, recording, and publication. Second, rodent, human-food animal, and nonhuman primates whole-body biochemical composition analysis and determination, recording, and publication. Third, rodent, human-food animal, and nonhuman primates cancer cure biotech, neurological diseases cure biotech, infectious diseases cure biotech, anti-aging and deaging biotech, genetic engineering biotech, and neurotech development, result recording and publication.
The Robocentric biotech development lab will have enough space for breeding and nurturing all the lab animals–rodents, human-food animals, nonhuman primates, and many more.
At Robocentric, GE-NHP means Genetically Engineered NonHuman Primate. Robocentric will do GE-NHP biomolecule, cell component, cell, tissue, organ, limb, and whole-body manufacturing and replacement experiments for developing human body manufacturing and replacement biotech.
My view is avoiding live animal testing to the maximum extent possible, especially nonhuman primate testing, opting to use manufactured human and nonhuman biomolecules, cell components, cells, tissues, organs, and limbs instead.
Performing tests on live research-lab animals is something I would love to avoid in developing medical biotech, human longevity biotech, and human fertility duration lengthening biotech, because I prefer to avoid harming animals, but for now I think some degree of live research-lab animal testing will probably have to be done to some extent in developing medical biotech, human longevity biotech, and human fertility duration lengthening biotech. I want to avoid doing experiments on nonhuman primates, so I'll avoid it to the maximum extent possible.
But I'm aware that some difficult choices will have to be made in performing tests on live research-lab animals, especially nonhuman primates. For example, when developing a human genetic engineering biotech for curing a genetically caused human blindness, blindness cure genetic engineering tests must be performed on nonhuman primates, such as monkeys, chimpanzees, and other apes—before human clinical trials—and the test-subject nonhuman primates will have to euthanized and dissected, and their body parts will have to be photographed, microscoped, spectroscoped, biochemically analyzed, recorded, and published for advancing bioscience and biotechnology.
Sacrificing nonhuman animal lives to protect and save human lives is a difficult choice to make; but I'm aware that it's a difficult decision that must be made, and a difficult act that must be performed, because that is the only way to develop human disease cures and protect and safeguard human lives. So, when the time comes, I'll plan, direct, coordinate, fund, and publicly communicate performing tests on live research-lab animals, for developing medical biotech, human longevity biotech, and human fertility duration lengthening biotech.
At Robocentric Biotech, first and foremost, biotech development experiments will be done on the animals excluded from the Animal Welfare Act—namely, "birds (such as turkey and chicken), rats of the genus Rattus, and mice of the genus Mus, bred for use in research, and cold-blooded animals, insects, and invertebrates".
Biotech development experiments on the species of animals covered by the Animal Welfare Act will be done according to the regulation.
Starting with microscopic 3D biomatter scanning, biomatter biochemical analysis and determination, genetic engineering, biomatter manufacturing and replacement testing, neurotech testing on lab-research birds, rats, mice, cold-blooded animals, insects, and invertebrates—then expanding to the species of animals covered by the Animal Welfare Act according to the regulation.
Robocentric will do research on developing nonhuman-primate artificial wombs, for developing human fertility disease and disability cures, and lengthening human fertility periods.
Robocentric will design and publish triple-walled lab animal enclosures—initially for birds, rats, mice, cold-blooded animals, insects, and invertebrates—with security and survelliance cameras, then eventually for the animals covered by the Animal Welfare Act (AWA) for expanding biotech development experiments with a licensing by and registration with USDA under the AWA or Animal Welfare Act.
Before each lab-animal surgery for biotech development and testing, Robocentric will notify the relevant federal, state, and local government agencies and relevant institutions (such as National Institutes of Health) in writing.
Robocentric will constantly report to the relevant federal, state, and local government agencies, and related organizations and institutions, when doing live animal testing for biotech development, with citing their laws, their promotions, their policies, and their recommended practices—as a part of Robocentric biotech development and commercialization process constellation.
In doing animal testing for biotech development and commercialization, Robocentric will work with the applicable U.S. federal government agencies (namely, FDA, USDA, and DEA if using controlled substances in animal testing), state government agencies (namely state board of pharmacy and state board of veterinary medical examiners), and local government agencies. Robocentric will also work with relevant institutions and organizations such as National Institutes of Health, and American Veterinary Medical Association (AVMA).
​
You can invest in my startup company with as little as US$100, for supporting advancing AI, robotics, biotech, and nuclear-fusion powered outer space tech. Visit https://Robocentric.com/Investors to invest in my startup.
My books on advancing AI, robotics, biotech, and nuclear-fusion powered outer space tech are available at https://Robocentric.com/Checkout/, Amazon, Apple Books, Spotify, and other audiobook outlets.
Allen Young's books on AI, robotics, biotech, and nuclear-fusion tech
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The Future: How artificial intelligence, robotics, human body biotech, and mass-scale outer space tech will alter the human reality (https://www.amazon.com/dp/B0B1XD1DJJ)
The Integrated Artificial Intelligence, Robotics, Human Body Biotech, and Mass-Scale Outer Space Tech Promotion, Research, Development, and Commercialization (https://www.amazon.com/dp/B0B2QH1PHR)
Transhumanistic Solar System (https://www.amazon.com/dp/B0BQZHSZKJ)
Defining Intelligence: What Artificial Intelligence Should Be (https://www.amazon.com/dp/B0BRDK3F3H)
Human Creativity Analysis: For Advancing Artificial Intelligence and Robotics (https://www.amazon.com/dp/B0BRTKWNBV)
Human Psychology and Language Analysis: For Advancing Linguistic Artificial Intelligence (https://www.amazon.com/dp/B0BSG3CG84)
America Robotization Plan: Plan for Doubling the American National GDP by Adding AI and Robots to the American National Economy (https://www.amazon.com/dp/B0BXTRK45Y)
​
My contact info is at https://Robocentric.com/Contact. Contact me if you want to discuss investing in Robocentric.

This Reddit post is made to show low MCAT applicants that it is possible. I do not recommend having a low GPA or MCAT. Still, sometimes that is the reality of the situation. Hence, I want to share my story and experience to hopefully give hope to others.
I typed out my resume below and removed my personal info for anonymity. So usually, when I read these posts on the thread, low mcats are described as 505ish. That is true, but as you can see, I am indeed a low mcat score who received 4 acceptances (2 md WlA and 2 A's from DO).
Things I wish I knew: 1) A low GPA and MCAT are pains in the butt and will make this process harder. Before applying, I went through the entire database of medical schools to see which schools would let my application through. I emailed tons of admissions offices and explained my situation. Most were helpful, saying my application would or would not be screened out. 2) If your scores are low, you need something allowing committee members to go to bat for you. I was a very research-heavy candidate and relied on that and my student job/volunteer work to craft my personal statement and discuss it in interviews. ( I was grilled in one interview that I looked like a Ph.D. candidate and not a medical school applicant, and this was a valid critique) 3) This process is long, and everyone is different. I had friends who received no interviews and others with 3+ acceptances and scholarships. You need a support system to keep you from going crazy. 4)Apply early. ADCOMs have a difficult job and will look for any reason to screen applicants out, and I didn't have the luxury of getting another strike by being late to apply. 5) The WL is not a death sentence. Schools often take the high scorers first to inflate their MCAT and GPA to soften the blow for individuals with lower scorers that they "are taking a chance on" 6) Avoid SDN and Reddit at all costs. If you have a question, ask it, receive an answer, and leave immediately. These websites are a blessing and a curse, full of information, but the people here are hardcore, blunt, and neurotic. 7) You have to plan everything. There is little room for error, and turning in primaries and secondaries is critical (don't rush but move with some urgency). Prewrite essays, and don't try to reinvent the wheel. If you aren't passionate about this, leave immediately not worth your time or money. 8)Craft your list carefully. I didn't qualify for FAP, but I am not a trust fund baby by any standards. I was very selective in the schools I applied to and selected them because I liked their missions, and I knew they would actually look at my application. No point in wasting money that I could spend elsewhere. 9) Your essays need to get you in the door. While your interviews need to show them something. Mentors from other programs read my essays and helped with mock interviews. I had the belief that I needed an opportunity to meet the members and that I could show them I was a good candidate for their school. The people reading your apps and interviewing aren't idiots; they will see your BS. Take some time to think about why you are doing this. 10) The deck may be stacked against you, but not everyone matriculating has a 3.8 and 510+. Some people have low stats, and others got off the WL. It only takes one, I promise.
You can do this!!
Stats: URM From a Northeastern State HBCU graduate MCAT 1st attempt: 501 MCAT 2nd attempt: 497 Cum GPA: 3.68/ ScGPA:3.45 (Repeated orgo II received a D) ECs: 2-year Fellowship/Postbacc at NIH Summer Research Internship @ MIT 2 years of Neuroscience Research in Undergrad (Poster Presentation) Honors Biology Lab (Poster presentation) Awards: University Scholarship to study abroad Business Competition 3rd place award Hackathon award winner Skills: MATLab (intermediate) R-Studio Analysis(novice) C-Sharp (novice)
Community Service: Student Advisor in Guidance -(full-time position 1500+ hours) Something Leadership Initiative (2-week service trip in an African country) Local food bank- 120 hours Honors Society Tutor for students with disabilities- 120 hours
Clinical Experience: Medical Shadow, "Blank" Medical Hospital 150 hours Medical Scholar, Summer Health Professions Education Program "50 shadow hours
Conferences Attended: MIT research Symposium-oral NIH research week-poster Axel Rod symposium-poster Society For Neuroscience-poster "my university research week"- poster

This Reddit post is made to show low MCAT applicants that it is possible. I do not recommend having a low GPA or MCAT. Still, sometimes that is the reality of the situation. Hence, I want to share my story and experience to hopefully give hope to others.
I typed out my resume below and removed my personal info for anonymity. So usually, when I read these posts on the thread, low mcats are described as 505ish. That is true, but as you can see, I am indeed a low mcat score who received 4 acceptances (2 md WlA and 2 A's from DO).
Things I wish I knew: 1) A low GPA and MCAT are pains in the butt and will make this process harder. Before applying, I went through the entire database of medical schools to see which schools would let my application through. I emailed tons of admissions offices and explained my situation. Most were helpful, saying my application would or would not be screened out. 2) If your scores are low, you need something allowing committee members to go to bat for you. I was a very research-heavy candidate and relied on that and my student job/volunteer work to craft my personal statement and discuss it in interviews. ( I was grilled in one interview that I looked like a Ph.D. candidate and not a medical school applicant, and this was a valid critique) 3) This process is long, and everyone is different. I had friends who received no interviews and others with 3+ acceptances and scholarships. You need a support system to keep you from going crazy. 4)Apply early. ADCOMs have a difficult job and will look for any reason to screen applicants out, and I didn't have the luxury of getting another strike by being late to apply. 5) The WL is not a death sentence. Schools often take the high scorers first to inflate their MCAT and GPA to soften the blow for individuals with lower scorers that they "are taking a chance on" 6) Avoid SDN and Reddit at all costs. If you have a question, ask it, receive an answer, and leave immediately. These websites are a blessing and a curse, full of information, but the people here are hardcore, blunt, and neurotic. 7) You have to plan everything. There is little room for error, and turning in primaries and secondaries is critical (don't rush but move with some urgency). Prewrite essays, and don't try to reinvent the wheel. If you aren't passionate about this, leave immediately not worth your time or money. 8)Craft your list carefully. I didn't qualify for FAP, but I am not a trust fund baby by any standards. I was very selective in the schools I applied to and selected them because I liked their missions, and I knew they would actually look at my application. No point in wasting money that I could spend elsewhere. 9) Your essays need to get you in the door. While your interviews need to show them something. Mentors from other programs read my essays and helped with mock interviews. I had the belief that I needed an opportunity to meet the members and that I could show them I was a good candidate for their school. The people reading your apps and interviewing aren't idiots; they will see your BS. Take some time to think about why you are doing this. 10) The deck may be stacked against you, but not everyone matriculating has a 3.8 and 510+. Some people have low stats, and others got off the WL. It only takes one, I promise.
You can do this!!
Stats: URM From a Northeastern State HBCU graduate MCAT 1st attempt: 501 MCAT 2nd attempt: 497 Cum GPA: 3.68/ ScGPA:3.45 (Repeated orgo II received a D) ECs: 2-year Fellowship/Postbacc at NIH Summer Research Internship @ MIT 2 years of Neuroscience Research in Undergrad (Poster Presentation) Honors Biology Lab (Poster presentation) Awards: University Scholarship to study abroad Business Competition 3rd place award Hackathon award winner Skills: MATLab (intermediate) R-Studio Analysis(novice) C-Sharp (novice)
Community Service: Student Advisor in Guidance -(full-time position 1500+ hours) Something Leadership Initiative (2-week service trip in an African country) Local food bank- 120 hours Honors Society Tutor for students with disabilities- 120 hours
Clinical Experience: Medical Shadow, "Blank" Medical Hospital 150 hours Medical Scholar, Summer Health Professions Education Program "50 shadow hours
Conferences Attended: MIT research Symposium-oral NIH research week-poster Axel Rod symposium-poster Society For Neuroscience-poster "my university research week"- poster
School list: Md: Howard-Wl Meharry Morehouse Loyola-WL->A Tulane-WL->A Hackensack Meridian
Do: Rowan SOM-A Ohio heritage KCUCOM-A PCOM MSUCOM Atsu Message me if you have any questions

Timestamp: https://imgur.com/a/2LvdiBK
This is one of the biggest sales I have done and its in response to some major life milestones, nothing bad but need to reprioritize and sell a lot of gear I can live without on a lot of my excess builds.
Some ground rules:

• Please try to refer to the item number, and if you want additional details or pictures I will respond as quickly as possible.
  
• This is intended to be a fundrasier for non gun stuff unfortunately and at this time NO TRADES, thanks for understanding
  
• A Dibs Takes precedence over a PM to haggle which itself takes precedence over a Question for information
  
• I have a lot going on in my life and may take a few to several days depending on how many items I sell, I try to pride myself on being as quick and reliable as possible however finding enough packing material and shipping this all will take some time - ASKING FOR A STATUS OR “haVe yOu ShipPeD yET” WILL BE IGNORED. You will get a tracking number and I will do my best effort to communicate but be forewarned.
  
• Almost all items have the OEM boxes, screws, etc unless otherwise noted you will be good to go to install on delivery
  
• Please respond within 30 minutes or less or you may be passed on for a second dibser
  
• Discounts given for bundles
  

——————————————————
Now that that’s out of the way:
OPTICS

1. Sig Sauer Tango6 1-6 in Anodized Gray, SFP, 30mm, HellfirePlex Reticle which is a dual illuminated fibeLED dot. Incredibly similar glass and performance to a Vortex Razor 1-6 in a better budget package albeit with a more straightforward reticle, capped turrets and throw lever, box and papers included - $600 shipped
   
2. PA SLx MD25 Single Dot, Gen 1 not shake awake, like new, with low mount, and riser mount with three spacer heights and all paperwork but not factory box, fantastic red dot that blends the best of a micro dot and a fullsize COMP dot - $60 shipped SOLD
   
3. Holosun 510c ery good condition with only some minor housing wear if any, red reticle, no factory box but will ship padded and insured - $220 shipped SOLD
   
4. FDE Deltapoint Pro 2.5MOA with a low mount and factory rubber cover and screws - $325 shipped
   
5. Holosun 407c V2, single dot, BIG BUTTON version, no factory box but includes screws, very good condition - $225 shipped
   

MOUNTS

1. Arisaka Micro Mount 1.7” Height, really solid underrated mount, comes spray painted wolf gray, if you give me a couple days I can clean it - $60 shipped
   
2. Badger Ordnance 30mm Scope Mount COMM, good condition 1.7”, 0MOA, want to include if possible this JArm and Micro Plate and ACRO plate - $250 shipped SOLD JArm and Plates Still Available, Mount sold
   

AR STUFF

1. My Gucciish Competition Upper - Lantac Dragon, 16” BA Hanson Premium 1:8 Twist .223 Wylde, Wojtek Adjustable Gas Block, Aero S-One 15” Handguard Cerakoted a custom “tanodized” color, Ripcord Clear Anodized Upper with a FCD Double Dimp Rose Gold Dust Cover, FCDxHodge Dimpled FA, and some rail panels -$700 OBO
   
2. Reptilia RECCE Stock, FDE, some light install marks that get covered, otherwise great condition, really awesome, ultralight stock, the cooler UBR - $100 shipped SOLD
   
3. Daniel Defense Tornado Gray Stock with both stock pads, very great condition - $45 shipped SOLD
   
4. Griffin ECS Maritime Stock, Gray, $25 shipped
   
5. Cloud Defensive CORv3 Handguard, 10.7”, Clear Anodized, Long recessed rail segment to allow Laser and Tape switches to be below the window of Lower 1/3 and higher optics and flush with receiver height, will come with all necessary hardware to install but you will need your own armorers wrench tool. Was installed and removed may show minor install and MLOK attachment marks but great overall condition - $150 shipped
   
6. B5 Systems Gray Pistol Grip with screw, I did a homebrew epoxy/grit powder grip and imo it came out pretty nice - $25 shipped SOLD
   
7. Railscales Polymer RSB-M in Stealth Gray, like new, $20 shipped SOLD
   

LIGHTS

1. Cloud Defensive REIN 3.0 FDE full kit with light, charger, Picatinny mount, and tape switch and an FDE flip up cap, mounted and removed but never shot with - $250 shipped SOLD
   
2. Tan Surefire X300U-A with all keys, great condition - $200 shipped
   
3. Modlite PLHv2 Head, Black, minor housing wear but very clear lens, ships with a One Hundred Concepts cover - $160 shipped SOLD
   
4. Cloud Defensive/IWC Offset Scout Mount, MLOK, Black, very good condition - $30 shipped
   

NYLON

1. Trex Arms Ready Rig, Wolf Gray, fitted and loaded with mags but almost never larped in ,just been sitting - $75 shipped

SLINGS (First One will Come with a Pair of QD Points Free! Ferro Concepts Brand)

1. LBX MAS Gray 2 Point Sling with an Upgraded Ferro Concepts Adjuster and Sling Silencer - $40 shipped
   
2. ESD Snow Camo Sling - $40 shipped SOLD
   
3. Defense Mechanisms Sling, Wolf Gray with Built in Rilfe Elastic mounting - $40 shipped
   

GLOCK STUFF

1. Glock 19 Gen 5 Slide, Jagerwerks F9 Cut/ACRO Footprint/Chamfered Edges/Enhanced Rear Serrations/Carbon End Plate/Nitride/All Internals/OEM Marksman Barrel from Black Phoenix Customs removing the unmatched rollmark and then Nitrided/OEM Iron Sights - $750 shipped
   
2. Zev G17.3 Barrel, Bronze, Dimpled, very low round count with no significant wear - $150 shipped
   
3. Zev Lightened Striker Spring/Red Channel Liner and Zev Extractor (Gen 3 or 4) - $40 shipped
   
4. Agency Arms AOS Plate for Glock, DeltaPoint Pro, Irons Front with Ameriglo 5XL Cowitness Irons installed (Black ReaTritium Front) - $80 shipped
   

OTHER

1. CHPWS 509t Plate for a PDP Gen 1 cut, - $40 shipped
   
2. Pair of Random Docter Optic Plates for Pic Rail from a FastFire 3 and a Vortex Venom box - Free + Shipping Cost if you want them SOLD
   

Thank you all for looking and I appreciate you all!

he International Scoliosis Research Society defines early onset scoliosis (EOS) as the various types of scoliosis that occur within 10 years of age (1). EOS leads to distortion of body appearance and reduced heart and lung function, which often limits the development of the chest and even oppresses the spinal cord, resulting in paralysis (2). A large-scale demographic study showed that an increase in altitude negatively correlated with newborn birth weight. Moreover, neonatal body weight shows obvious changes when the altitude exceeds 2500 m (3, 4). Based on relevant studies, we defined an area with an altitude above 3000 m as a high-altitude area and an area with an altitude below 500 m as a plain area (5). High-altitude environments consists of low air pressure, hypoxia, and cold weather, all of which impact the cardiopulmonary function and structure of the human body. Such high-altitude environments increase cardiac output, pulmonary ventilation, pulmonary capillary hyperplasia, and other compensatory reactions (6, 7). However, there are limited studies on the effects of high-altitude environments on cardiopulmonary function in patients with EOS. Therefore, this study aimed to determine the effects of high altitude on the respiratory and circulatory systems of patients with EOS by comparing blood gas analysis results and cardiopulmonary function between the high-altitude and plain area groups. In addition, we explored how scoliosis affected patients' cardiopulmonary function by analyzing the correlations between scoliosis imaging parameters and cardiopulmonary function measures. We aimed to provide an improved preoperative evaluation and postoperative rehabilitation for EOS patients living in high-altitude areas.
Inclusion and exclusion criteria A retrospective cohort study was conducted to identify patients with EOS between June 2013 and June 2021. The inclusion criteria were: (1) EOS patients with a long-term living altitude >3000 m or living area altitude <500 m; (2) full-length anteroposterior and lateral radiographs of the spine showing scoliosis of mainly the thoracic curvature type; (3) patients with an aggravated Cobb's angle >45°; (4) no treatment with braces or growth rods before evaluation; and (5) all patients knew of the study procedures and agreed to participate. The exclusion criteria were: (1) incomplete spinal radiography data; (2) patients who could not cooperate with the completion of pulmonary function examination, blood gas analysis, and cardiac color ultrasound; and (3) patients with congenital cardio-cerebrovascular diseases, syndrome scoliosis, and previous spinal surgery. Evaluation methods Patient records and relevant data were collected retrospectively. All patients underwent full-length anteroposterior and lateral spine radiographs, blood gas analysis, lung function examination, and heart color ultrasound examination. Imaging parameters Preoperatively, whole-body and lateral spinal X-rays were performed on all patients, and both shoulders were flexed anteriorly during X-ray examination to ensure the most natural state of lumbar lordosis. The imaging parameters were as follows: (1) kyphosis angle of the thoracic (kypho), (2) upper thoracic curve (UT), and (3) main thoracic curve (MT). MT measures the Cobb angle from the head side of the T3 upper endplate to the T12 lower endplate. The UT measures the Cobb angle from the T1 upper endplate to the T3 lower endplate on the cephalic side. Kypho measures the Cobb angle from the upper endplate of the cephalic T2 vertebral body to the lower endplate of the caudal T5 vertebral body. All measurements used the Cobb method. The picture archiving and communication system was used by two independent observers. To test agreement among the observers, two orthopedic spine surgeons measured the imaging parameters twice independently, and the intraclass correlation coefficient was analyzed. Doppler echocardiography Color Doppler echocardiography indices were collected and recorded, including those of the pulmonary artery internal diameter (PAID), left ventricular end-systolic dimension (LVISD), ascendant aorta inner diameter, right ventricular basal diameter (RVBD), left atrium left-right diameter (LALRD), right atrium left-right diameter, left atrium longitudinal diameter, left atrium vertical diameter, peak late diastolic flow velocity (A peak), left ventricular early diastolic peak flow velocity (E peak), interventricular septum extent (IVSE), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), right atrium vertical diameter, and interventricular septum thickness. A color Doppler ultrasound instrument (Vivid E95, GE Healthcare) with an m5S probe was used. Patients were positioned in the left lateral decubitus position, and their electrocardiograms were recorded synchronously to obtain apical four-, 2 three-, and two-chamber heart section images for three consecutive cardiac cycles and acquire spectral Doppler images of the mitral and aortic valves. Routine parameter measurements were performed according to the American Society of Echocardiography guidelines, and the LVEF was determined using the biplane Simpson method. The patients’ imaging results were jointly rated by two experts in ultrasound imaging. Pulmonary function examination The indices of pulmonary function examination included forced vital capacity (FVC), forced expiratory flow in 1s (FEV1), percentage of predicted value, vital capacity (VC), and maximum ventilation (MVV). Preoperative pulmonary function examination was performed using the JAEGER Oxycon Pro with a unified baseline (CareFusion Germany 234 GmbH, Hochberg, Germany). A lung function detector (JAEGER Master Screen PFT, CareFusion Germany 234 GmbH, Hochberg, Germany) was used for measurement. A lung function detector was used for measurement, and the measurement module included pulse oscillation lung function, conventional lung capacity, velocity loop, residual gas function, dispersion function, and MVV rate. Lung function test results were obtained using JLab 5.7 software (CareFusion Germany 234 GmbH, Hochberg, Germany). Blood gas analysis Blood gas analysis indices included blood oxygen saturation (SO2%), hematocrit (Hct), partial pressure of oxygen (pO2), total hemoglobin (Hb), and partial pressure of carbon dioxide (pCO2). Two independent observers recorded these indices. To test for inter-rater agreement, the reported outcomes were recorded twice independently by two orthopedic surgeons, and the recorded data were reconciled. Statistical methods The data were analyzed using SPSS 23.0 software, and the data were expressed as`x±s, where`x and s stand for the mean and standard deviation, respectively. An independent sample t-test was used to compare the measurement data between the two groups, and the χ2 test was used for counting data. Differences were considered statistically significant at P<0.05. The correlation among the parameters was determined using Spearman’s correlation coefficient and analyzed using Origin 2021 software. General data Based on the inclusion and exclusion criteria, 38 and 66 EOS patients were enrolled in the high-altitude and plain area groups, respectively. The high-altitude group comprised 20 boys and 18 girls, with a mean age of 8.42 years (range, 6–10 years). The plain area group comprised 26 boys and 40 girls, with a mean age of 8.77 years (range, 4–11 years). The average age of the high-altitude group was not significantly different from that of the plain area group (P>0.05). The body weight and height of the high-altitude group were significantly lower than that of the plain area group; however, there was no significant difference in the body mass index between the two groups. The average Cobb’s angle was 79.65°, and the average thoracic kypho was 60.16°. There was no significant difference in the degree of other spinal deformities between the two groups. The thoracic spine curves of both the groups were mainly on the right side, and the proportion of right kyphosis in the high-altitude and plain area groups was 63.16 and 66.67%, respectively, with no significant difference (P>0.05). There were 48 cases of idiopathic scoliosis, 16 of congenital scoliosis, two of 3 neuromuscular scoliosis, and 24 cases of idiopathic scoliosis in the plain area group; there were 14 cases of congenital scoliosis in the high-altitude group. There was no significant difference in the proportion of patients diagnosed with idiopathic scoliosis between both groups (P>0.05). Color Doppler echocardiography examination The PAID, LVEDD, and IVST in the high-altitude group were significantly lower than those in the plain area group (P<0.05). There were no significant differences in the other cardiac color ultrasound indices, and were within the normal range. Pulmonary function examination The results of the pulmonary function examination showed that the FVC, VC, and MVV in the high-altitude group were significantly lower than those in the plain area group (P<0.05). The average predicted FVC% values in the high-altitude and plain area groups were 77.81 and 73.77%, respectively, and the average predicted FEV1% values were 78.65 and 73.05%, respectively (P>0.05), showing mild restrictive and obstructive ventilatory dysfunction. Blood gas analysis The Hct levels of the plain area group (38.49±2.89%) were significantly lower than those of the high-altitude group (40.85±4.47%; P<0.05). Hb levels in the high-altitude group (13.67 ± 1.46 g/L) were significantly higher than those in the plain group (12.85±0.94 g/L; P<0.05). The pCO2 levels of the high-altitude group (33.44±4.7 mmHg) were significantly lower than those of the plain area group (35.92±4.66 mmHg; P<0.05); however, there was no significant between-group difference in pO2 and SO2% levels (P>0.05). Correlations of parameters The correlation analysis between the spinal parameters and cardiopulmonary function measures in the high-altitude group is significant. In the high-altitude group, there was a significant correlation between the angle of the main thoracic curvature, the angle of the upper thoracic curvature, and kyphosis (rho=0.692, rho=0.484). There was a significant correlation between the kypho and upper chest curvature angles (rho=0.519). There was a significant correlation between LVISD, IVSE, RVBD, LALRD, and the MT (rho=-0.399, rho=0.565, rho=-0.358, rho=-0.371); however, there was no significant correlation between the angle of kyphosis and echocardiography index. PO2 and SO2% levels correlated with the angle of the MT (rho=-0.400, rho=-0.406). The upper chest bend angle was significantly correlated with VC, MVV, FVC, and FEV1 (rho=-0.498, rho=-0.451, rho=-0.513, rho=-0.588), while the upper chest bend angle and kyphosis bend were not significantly correlated with the pulmonary function index. There was a significant linear correlation between the UT and FEV1, FVC, and MVV in the high-altitude group. FEV1=1.623-0.011*UT, FVC=1.858-0.012*UT, MVV=54.646-0.286*UT. The results of the correlation analysis between imaging indices and cardiopulmonary function indices indicated that in the high-altitude group, UT showed a clear negative correlation with VC, FEV1, FVC, and MVV. In contrast, UT showed a clear positive correlation with these indices in the plain area group. In the high-altitude group, MT showed no obvious correlation with lung function indexes, whereas in the plain area group, MT showed a negative correlation with lung function indices. Scoliosis is a complex three-dimensional deformity that leads to distortion of body 4 appearance and reduced organ function, often causing irreversible damage to cardiopulmonary function (8, 9). Scoliosis due to rotation and thoracic scoliosis leads to a decrease in thoracic volume and asymmetry between the left and right thorax, which seriously affects the normal development of cardiopulmonary function in patients. The thoracic volume is vital for the development of cardiopulmonary function in children. Studies have shown that the critical period of alveolar and thoracic development in children occurs before the age of 10 years. Alveolar development in children approximately 10 years old is as prevalent as in adults, and the thoracic volume can reach half of that in adults (10, 11). Therefore, alveolar and thoracic development in EOS patients is critical since scoliosis and thoracic deformities can lead to pulmonary dysplasia. Most researchers believe that poor cardiopulmonary function in patients with scoliosis is caused by mechanical compression of bone tissue (12). Tsiligiannis et al. (13) showed that scoliosis changes the position of thoracic organs and affects normal respiratory movement, resulting in restrictive ventilation disorders. Campbell et al. (2) indicated that congenital scoliosis in patients with rib deformities could cause thoracic deformities, affects the normal development of heart and lung function and often leads to thoracic insufficiency syndrome. However, other studies have suggested that lung function is mainly affected by the limited development of the heart and lung caused by scoliosis rather than the mechanical compression caused by simple thoracic deformities (14). Davies et al. and Berend et al. (12, 15, 16) performed autopsy studies on EOS patients. They showed no obvious abnormality in the shape of alveoli, a decreased total number of alveoli, and no decrease in the size of alveoli due to thoracic compression and no decrease in the size of alveoli due to thoracic compression (the size was found to be compensated). Koumbourlis (17) et al. studied the relationship between scoliosis and patients’ circulatory and respiratory functions. They discovered that scoliosis-related deformities prevent patients from exercising like their normal peers, which reduces the number of chest breaths and compensates for the number of abdominal breaths. Regarding the thoracic structure, scoliosis limits the normal development of the chest, causing deformation of the important cardiovascular compression, leading to cardiopulmonary dysfunction. High-altitude areas exhibit a unique geographical environment comprising factors such as low pressure, low PO2, and low air content. Living in low-oxygen and thin-air environments over a long period impacts the development of cardiopulmonary function. An independent risk factor for low birth weight in newborns is the high-altitude environment, which leads to fetal growth restriction and affects the function of the respiratory and cardiovascular systems (5, 18). When the altitude increases by 100 m, the ambient atmospheric pressure decreases by 5 mmHg. Because the oxygen concentration in the atmosphere is constant, the oxygen partial pressure will decrease by approximately 1 mmHg. At sea level, the average pO2 is 150 mmHg. When the altitude is between 3000 and 5500 m, the PO2 decreases between 80 and 100 mmHg. When exposed to hypoxia and a hypobaric environment, people living in a plateau environment will have compensatory regulatory responses to restore the body's internal homeostasis. Over the course of natural selection, this compensatory response may be passed on to offspring through genetic material. The compensatory responses of people at high altitudes to hypoxia and hypobaric environments include increased pulmonary blood perfusion, erythrocytosis, blood viscosity, lung tissue compliance, and a slight increase in 5 pulmonary artery pressure. Studies have shown that people in high-altitude environments have symptoms of right ventricular hypertrophy and pulmonary hypertension, and elevated Hb levels in the body (19-21). In this study, the chest curve was the main bend in EOS patients in plain and high-altitude areas, with Cobb's angle of the main bend >45° in all patients. There was no significant between-group difference in the direction and severity of scoliosis and kyphosis. Idiopathic scoliosis is the primary classification of scoliosis. Excluding congenital cardiac developmental abnormalities, pulmonary artery diameter, LVEDD, and inter-ventricular septum thickness in the high-altitude group were smaller than that in the plain area group. This may be due to structural abnormalities of the heart and lungs caused by long-term low pressure and lack of oxygen in high-altitude areas. To explore the relationship between scoliosis, cardiopulmonary function, and the effect of high altitude on cardiopulmonary function, a correlation analysis was performed. The UT angle in the high-altitude group was correlated with the pulmonary function examination indexes (VC, MVV, FVC, and FEV1), while the UT angle in the plain area group was not significantly correlated with these indexes. Long-term exposure to high and cold climates, low pressure, and low oxygen environments impact the cardiopulmonary structure of patients in high-altitude areas. Therefore, the reduction in thoracic space caused by changes in spinal structure will cause more serious damage to the cardiopulmonary function of patients in high-altitude areas compared to patients in plain areas (22). Therefore, patients with severe scoliosis in high-altitude areas require active surgical intervention to reduce cardiorespiratory impairment associated with scoliosis. The results of pulmonary function tests showed that the average values of FEV1% and FVC% in both groups were < 80%, and there were mild restrictive and obstructive ventilation disorders, indicating that scoliosis and thoracic deformities limited the normal respiratory function of patients. The FVC, VC, and MVV indices of the high-altitude group were significantly lower than those of the plain area group. This could be due to the following: the low temperature at high altitudes contracts the small airways of the lungs and increases ventilatory resistance; the hypobaric and hypoxic environment forces the patients to breathe more times per unit time, increasing the load of respiratory muscles and causing respiratory muscle fatigue; the nutritional status of patients in high-altitude areas is worse than that of patients in plain areas; and the thoracic volume is smaller in patients in high-altitude areas than that of patients in plain areas. Scoliosis with thoracic deformity is often accompanied by limited diaphragm function and decreased chest volume, which leads to a decrease in lung tissue pressure and compliance, pulmonary hypertension, and even serious diseases such as cor pulmonale and respiratory failure (23). Studies have shown that pulmonary dysfunction before surgical treatment increases perioperative respiratory complications such as respiratory insufficiency, atelectasis, and pneumonia (24). Therefore, during clinical treatment, more attention should be paid to evaluating pulmonary function in EOS patients before surgery. For patients at high altitudes or other EOS patients with significantly impaired pulmonary function, it is necessary to carry out preoperative respiratory function training to improve respiratory function (25) and surgical safety and reduce postoperative complications; the comprehensive evaluation of pulmonary function in combination with other disciplines is also possible. 6 Because of the lack of studies comparing lung function between EOS patients in high-altitude and plain areas that are similar to our patient population, it cannot be ruled out whether the decline in lung function indices is affected by spinal deformities. In this study, the number of patients in high-altitude areas was less than that of patients in plain areas. Our results may not be comprehensive enough as there were only a few categories of imaging parameters; therefore, it was difficult to analyze the correlation between other imaging parameters and cardiopulmonary function. Conclusion EOS patients in high-altitude areas had poorer cardiac and pulmonary functions than those who live in plain areas. Cardiopulmonary function and the degree of scoliosis interact with each other. We should pay more attention to preoperative evaluation and postoperative rehabilitation for EOS patients living in high-altitude areas. References: 1.Fletcher ND, Bruce RW. Early onset scoliosis: current concepts and controversies. Curr Rev Musculoskelet Med.(2012)5: 102-10. doi:10.1007/s12178-012-9116-0 2.Campbell RJ, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, Pinero RF, Alder ME, Duong HL, Surber JL. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J BONE JOINT SURG AM.(2003)85: 399-408. doi:10.2106/00004623-200303000-00001 3.Mortola JP, Frappell PB, Aguero L, Armstrong K. Birth weight and altitude: a study in Peruvian communities. J Pediatr.(2000)136: 324-9. doi:10.1067/mpd.2000.103507 4.Zhou L, Yang H, Hai Y, Hai JJ, Cheng Y, Yin P, Yang J, Zhang Y, Wang Y, Zhang Y, Han B. Scoliosis among children in Qinghai-Tibetan Plateau of China: A cross-sectional epidemiological study. Front Public Health.(2022)10: 983095. doi:10.3389/fpubh.2022.983095 5.Jensen GM, Moore LG. The effect of high altitude and other risk factors on birthweight: independent or interactive effects? AM J PUBLIC HEALTH.(1997)87: 1003-7. doi:10.2105/ajph.87.6.1003 6.Ostadal B, Kolar F. Cardiac adaptation to chronic high-altitude hypoxia: beneficial and adverse effects. Respir Physiol Neurobiol.(2007)158: 224-36. doi:10.1016/j.resp.2007.03.005 7.Maggiorini M. Cardio-pulmonary interactions at high altitude. Pulmonary hypertension as a common denominator. ADV EXP MED BIOL.(2003)543: 177-89. doi:10.1007/978- 1-4419-8997-0_13 8.Kadoury S, Shen J, Parent S. Global geometric torsion estimation in adolescent idiopathic scoliosis. MED BIOL ENG COMPUT.(2014)52: 309-19. doi:10.1007/s11517 -013-1132-8 9.Charles YP, Dimeglio A, Marcoul M, Bourgin JF, Marcoul A, Bozonnat MC. Influence of idiopathic scoliosis on three-dimensional thoracic growth. Spine (Phila Pa 1976).(2008)33: 1209-18. doi:10.1097/BRS.0b013e3181715272 10.Boyden EA. Development of the pulmonary airways. Minn Med.(1971)54: 894-7. 11.Karol LA, Johnston C, Mladenov K, Schochet P, Walters P, Browne RH. Pulmonary function following early thoracic fusion in non-neuromuscular scoliosis. J BONE JOINT SURG AM.(2008)90: 1272-81. doi:10.2106/JBJS.G.00184 7 12.Day GA, Upadhyay SS, Ho EK, Leong JC, Ip M. Pulmonary functions in congenital scoliosis. Spine (Phila Pa 1976).(1994)19: 1027-31. doi:10.1097/00007632-199405000-00004 13.Tsiligiannis T, Grivas T. Pulmonary function in children with idiopathic scoliosis. Scoliosis.(2012)7: 7. doi:10.1186/1748-7161-7-7 14.Branthwaite MA. Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest.(1986)80: 360-9. doi:10.1016/0007-0971(86)90089-6 15.Berend N, Marlin GE. Arrest of alveolar multiplication in kyphoscoliosis. PATHOLOGY.(1979)11: 485-91. doi:10.3109/00313027909059026 16.Davies G, Reid L. Effect of scoliosis on growth of alveoli and pulmonary arteries and on right ventricle. ARCH DIS CHILD.(1971)46: 623-632. doi:10.1136/adc.46.249.623 17.Koumbourlis AC. Scoliosis and the respiratory system. PAEDIATR RESPIR REV.(2006)7: 152-60. doi:10.1016/j.prrv.2006.04.009 18.Krampl E, Lees C, Bland JM, Espinoza DJ, Moscoso G, Campbell S. Fetal Doppler velocimetry at high altitude. Ultrasound Obstet Gynecol.(2001)18: 329-34. doi:10.1046/j.0960-7692.2001.00542.x 19.Hulme CW, Ingram TE, Lonsdale-Eccles DA. Electrocardiographic evidence for right heart strain in asymptomatic children living in Tibet--a comparative study between Han Chinese and ethnic Tibetans. Wilderness Environ Med.(2003)14: 222-5. doi:10.1580/1080-6032(2003)14[222:eefrhs]2.0.co;2 20.Huicho L. Postnatal cardiopulmonary adaptations to high altitude. Respir Physiol Neurobiol.(2007)158: 190-203. doi:10.1016/j.resp.2007.05.004 21.CANEPA A, CHAVEZ R, HURTADO A, ROTTA A, VELASQUEZ T. Pulmonary circulation at sea level and at high altitudes. J APPL PHYSIOL.(1956)9: 328-36. doi:10.1152/jappl.1956.9.3.328 22.Penaloza D. Effects of high-altitude exposure on the pulmonary circulation. Rev Esp Cardiol (Engl Ed).(2012)65: 1075-8. doi:10.1016/j.recesp.2012.06.027 23.Sacks D, Baxter B, Campbell B, Carpenter JS, Cognard C, Dippel D, Eesa M, Fischer U, Hausegger K, Hirsch JA, Shazam HM, Jansen O, Jayaraman MV, Khalessi AA, Kluck BW, Lavine S, Meyers PM, Ramee S, Rufenacht DA, Schirmer CM, Vorwerk D. Multisociety Consensus Quality Improvement Revised Consensus Statement for Endovascular Therapy of Acute Ischemic Stroke. INT J STROKE.(2018)13: 612-632. doi:10.1177/1747493018778713 24.Zhang JG, Wang W, Qiu GX, Wang YP, Weng XS, Xu HG. The role of preoperative pulmonary function tests in the surgical treatment of scoliosis. Spine (Phila Pa 1976).(2005)30: 218-21. doi:10.1097/01.brs.0000150486.60895.a1 25.Liang J, Qiu G, Shen J, Zhang J, Wang Y, Li S, Zhao H. Predictive factors of postoperative pulmonary complications in scoliotic patients with moderate or severe pulmonary dysfunction. J SPINAL DISORD TECH.(2010)23: 388-92.doi:10. 1097/BSD.0b013e3181b55ff4

https://en.wikipedia.org/wiki/Steve_Kirsch
https://archive.ph/ybWuS
Steve Kirsch - Wikipedia
Alma mater Massachusetts Institute of Technology
Steven Todd Kirsch is an American entrepreneur. He has started several companies and was one of two people who independently invented the optical mouse. Kirsch has been both a philanthropic supporter of medical research, and a promoter of misinformation about COVID-19 vaccines.
Education
Kirsch received a Bachelor of Science and a Master of Science in electrical engineering and computer science from the Massachusetts Institute of Technology in 1980.[1]
Career
In 1980, Kirsch and Richard F. Lyon independently invented the first versions of the optical mouse.[2] Kirsch has started several companies. In 1993, he founded the search engine Infoseek, which in 1999 was sold to the Walt Disney Co.[3][4] He co-founded Frame Technology Corp., bought by Adobe in 1995.[5] In 2002 he was CEO of Propel Software.[4] In 2005 he founded Abaca, which made a spam filter.[6][7]
In September 2011, he started OneID[8] to create a user-centric Internet-scale digital identity system using public key cryptography to replace usernames and passwords with a digital identity compatible with the NSTIC[9] goals.[10]
Sometime before March 2021, Kirsch started M10, which markets blockchains for banks, but the board asked him to step down in the summer of 2021 amid controversy generated by his statements on COVID treatments and vaccines.[11][12]
COVID-19
In April 2020, Kirsch founded the COVID-19 Early Treatment Fund (CETF) to fund research into off-label treatments for COVID-19 among drugs already having FDA approval for other diseases, donating $1 million himself and also fundraising from others.[11][13] He recruited what MIT Technology Review called "a powerhouse board" of scientific advisors including Robert Siliciano and management by Rockefeller Philanthropy Advisors.[11] By October 2021 the fund had made grants totaling $4.5 million to various researchers.[11]
The fund found a "promising candidate" for further study in fluvoxamine, according to MIT Technology Review.[11] After funding a successful small trial which ended in November 2020, CETF provided further funding for a Phase 3 trial, which as of October 2021 was analyzing data.[11][12] Kirsch, frustrated that CETF's scientific advisory board was not willing to promote use of the drug based on results of a small preliminary study, wrote a post on Medium titled The Fast, Easy, Safe, Simple, Low-Cost Solution to COVID That Works 100% of the Time That Nobody Wants to Talk About. Medium removed his access to the site, citing misinformation concerns.[11] Kirsch also refused to accept the outcome of a CETF-funded study on hydroxychloroquine, which had found the drug ineffective; he eventually warred with CETF's scientific advisory board over CETF's treatment of both drugs to the extent that in May 2021 all 12 members resigned.[11]
Vaccine misinformation
In May 2021, Kirsch posted an article online claiming that COVID-19 vaccines affect fertility, while also underplaying the vaccines' ability to prevent illness and death, both statements criticized by fact checkers as being inaccurate and misleading.[14] In September 2021, speaking at an FDA meeting and identifying himself as CETF's executive director, Kirsch claimed that the vaccines "kill twice as many as they save"; the FDA responded that Kirsch had misinterpreted data and that there was no evidence his statement was true.[11][15]
Reuters assessed the claim as false.[15]
In October 2021, Kirsch founded the anti-vaccine group Vaccine Safety Research Foundation (VSRF),[16] which created ads depicting deaths the group attributed to vaccines.[17][18] Foundation advisors include Robert Malone, Peter McCullough, and Stephanie Seneff. Soon after, Kirsch appeared with Malone on the Bret Weinstein and Heather Heying podcast, which according to MIT Technical Review "introduced Kirsch to followers of the 'intellectual dark web'" and allowed him to access a "large and receptive audience to his claims about a fluvoxamine conspiracy".[11]
Personal life
Kirsch and his wife, Michele, fund a charitable foundation, which by 2007 had given $75 million to different causes.[11][19][20] Kirsch also was a noted contributor to Democratic Party related funds.[21][22] In 2007, his personal fortune was estimated at $230 million;[19] that same year he was diagnosed with a rare form of cancer and funded research into experimental treatments for it, eventually refocusing the family foundation on medical research.[11][19] As of 1998 the couple lived in Los Altos and had two children.[1]

I’d love some input on my school list so far, and advice on schools to add/subtract.
Stats: 3.7 gpa, 518 MCAT Clinical hours: 2k scribe, 3.5k in healthcare company not patient-facing (remote) Shadowing: 225 hrs sports med Clinical volunteer: 50 hrs vaccine clinic Non-clinical volunteer: 30+ hrs homeless org Research: 330 hrs clinical research in sports med (1 pub), 160 hrs lab research (1 pub), independent research for credit 1 semester (no pub) Other work exp/hobby: 1700 hrs carpentry, 500+ hrs Xmas tree farm, hobby playing sports (IM + men’s leagues)
My volunteer hours are obviously pretty low, so I’m not sure which schools that would be a problem with, ideally I’d like to apply to 20-25 MD and 5-7 DO.
MD -Brown -Albert Einstein -BU -Albany -Drexel -Netter -GWU -Geiser -Georgetown -Hackensack -Mt Sinai -Kaiser -Lewis Katz -Loyola -NY Medical College -UVM -Sidney Kimmel -Tufts -Tulane -UCLA -UMASS -U Miami -U Colorado -UCSF -Hofstra -Rochester
DO -UNE -Touro Harlem -Nova -PCOM -NYIT -Rocky Vista -Western U (Pomona) -Rocky Vista
Let me know if I should add any schools, and which would be best to cut out to reduce the total #

Hello, I am a URM with a 3.29 GPA and a 3.1 sGPA.
Got my MCAT score today, 512, (124 C/P 130 CARS 126 B/B P/S 132).
I have 100 hours research with more on the way, expected first name publication by the end of the year in a low-impact journal about Immigrant/Limited english health outcomes, 500ish hours clinical work with my EMT-B cert as a vaccinator during the pandemic and as a medical tech in a quarantine clinic providing aid to Covid positive refugees/asylum seekers. Non-clinical volunteering in a migrant shelter, helped give them food, shelter, etc as well as locate lost family members and travel.
One biology field degree and another bachelor's in Spanish medical/legal interpretation.
Only 14 hours shadowing rn, looking for more.
I'm sort of at a loss of what to do. I know my app is weak, with poor stats and low shadowing, but on the other hand I feel as if I've really crafted a strong narrative and track-record of helping the underserved and have unique stories from my work experience. My MCAT isn't horrible, but is not ideal when paired with my subpar GPA. I'm taking every step I can to improve my application for the next go around, but I'm sort of at a loss of what to do this cycle, or if it would be fruitful just to axe it for now and apply next go around, or if I should apply maybe to a couple schools like state schools this time and apply much more broadly next time? My goal is an MD program, not extraordinarily picky beyond that, I would be perfectly happy with a nice mid-level program.
As you can tell, I'm a bit disoriented and having a tough time actually evaluating my position right now. I'd love to hear brutal honest thoughts or ideas, and I'll answer any questions if you have any! Also, don't hold back, what I need most right now is honesty. I just need to form a strategy.

I'm tired of driving back and forth to my partner. It's been 2.5 years long-distance and it'll be another 2 years before we can even think about living together. I feel like we're stuck in this phase where it's just me driving back and forth to them. I work full-time, sometimes part-time and keep busy with hobbies. I rent a room b/c I honestly cannot afford to live alone on my salary. I've had shitty situations with roommates in the past. My partner is a full-time student in a doctorate program. I've noticed that both of us have gained a significant amount of weight throughout this relationship. I'm honestly afraid to look at the scale at this point. I've picked up really bad eating habits with them. I think this relationship brought on a different type of stress than I've been accustomed to.
The first year I met them, they weren't in school. So dynamics were a bit different. Lately, I've been reflecting and I feel like I give up my time, gas money, and energy to spend time with them when they have time. I've tried to be accommodating b/c school comes first but I have not been able to put myself first in this relationship. Even when I visit, I'm limited on the hours I can visit. Also they do not have an income so it's been very difficult. I've taken the financial responsibility to offset the costs of our dates, activities, events, or whatever. When we spend time w/ their family, that costs even more money that I cannot budget for or even expect b/c it just happens. Yet I make a pretty low salary for the cost of living in my area.
It doesn't feel fair to me. I'm always so exhausted and can't even stick to my budget b/c there are too many variables. They live rent free with their mom. They're currently full time in a doctorate program. So there is very little time for me. I've become accustomed to seeing them on a very rigid schedule. Sometimes we won't see each other for weeks. Texts/calls are limited in a way where I'm always told, "Well, I have to go or sorry to cut you off." At first I was very understanding and now I'm beyond frustrated b/c it feels like whenever I get comfortable in the conversation or with them, there is a limit and I'm cut off. Then other times it's like they're overwhelmingly wanting to spend time w/ me, in their time off affection, and etc... when I need to reacclimate to being around them in that capacity.
I'm not certain if I have the patience for another 2 years. I love this person greatly but this has been incredibly difficult and I find myself getting more and more frustrated even when we talk things out. I want to settle down. I want to live with my partner and start taking milestones towards settling down. I'm tired of the back and forth. I want to have a conversation without being cut off.
I've also been working on myself the past year. Started therapy, finding hobbies, and building social connections. Recently, I've been super involved in my hobbies. They came w/ me to one event and got upset w/ me, I felt bad, missed out on another event I planned on going to (even invited my partner) w/some friends but they weren't happy until I spent that time in the way they intended. I was so emotionally exhausted that I just cancelled everything for the remainder of the week. Another thing I cannot prepare for is when we're upset with each other and how draining that can be.They were mainly upset b/c they felt like I have a life outside of them and they're not included in my plans and they're struggling socially and they have absolutely nothing planned on their time off(they're doing clinical right now).I've literally planned so many of our dates in the past... I don't see why I always have to be responsible. It would honestly be nice if they planned something instead of expecting me to constantly take charge.I was also very upset and resentful that I didn't get to do the events I planned on doing and how I lost so much energy to do the things I wanted b/c of the whole situation.
I also feel like I want freedom, flexibility and my time back. I want to know if I intend to commit to something, nothing out of my control will prevent that. I've had to sacrifice so much for this relationship, time, money, inner peace, and energy. I've been really depressed lately and this relationship has only made it worse. They haven't even noticed that I'm actually depressed b/c they're so overwhelmed. When I communicate my frustrations or reasons why I'm upset they start crying and I feel guilty for saying how I feel or what frustrates me & it always goes back to how they're overwhelmed and how they can't handle things. I feel like I have to say what they want to hear b/c they're so sad but it's building resentment. Lots and lots of resentment. I am struggling with setting boundaries b/c for some reason I feel like this bad person when I try to. I don't know if this relationship is worth it. I don't know if I'm getting the things I need from it. I really don't know if sacrificing my sleep, my money, or my inner peace is worth the love, trust, and relationship I have with this person. I am so tired of going back and forth for nothing to change. I am so confused and cannot look at this objectively b/c they have made me feel incredibly loved, accepted, and make time/effort for me when they can. I just think the things I truly value from them aren't possible for a while and I don't know if this is something that'll pass with time or won't. They do make efforts in other ways but I'm honestly at the point where I don't think it's making any difference for me. I'm so conflicted between what I feel like I need and my love for them.

I live in the Midwest low cost of living btw.
I have a dime size tattoo on my inner forearm. It's a question mark and an exclamation point done as a stick and poke in India Ink like 5 years ago. I went to a poorly rated spa clinic (lol) because they offered free consults for tattoo removal and it is close to my house.
Got major sketch and bad vibes. He says why they are the best and how they guarantee removal and how they offer all the other stuff like scar removal if anything were to go wrong blah blah blahnlah blah.
He showed me pics of all the removal and was going HARD on how they can remove ANY AND ALL types of ink (like, dude, my only tattoo I want removed is black India ink I don't give a FUCK if it can remove purple glitter rainbow sparkles ink lol)
He then quoted me 200 dollars a session OR 1000 to guarantee removal if it ends up taking more than 5 sessions. He claims mine would've normally been 300 a session but he "knows why you want to remove it so we can help you out"
LMAO so sketchy. Idk if the quote is reasonable, it sounds ridiculous to me considering it's smaller than a dime, a shitty stick and poke, and done in India ink. Google claims those all can make it EASIER to remove but he said it'll make it harder but hey, I'm not the expert. I just looked on Google.
Definitely didn't like him claiming to be cutting me slack on the price and trying to upsell me on random treatments before I even agreed to the removal? He said first session could be same day. I was like "oh yeah I definitely won't be getting the removal today. I'm going to go home and think about it and give you guys a call."
I'm definitely not going there, but is that quote crazy or is it reasonable because I'd like to try another clinic or whatever to see if I can get it removed for maybe less than a grand for a microscopic tattoo 😂
I will definitely live with the tattoo before paying 80 hours worth of work for it. Hell, I'll take a scalpel to it before I pay a grand. Thanks!

I had three tests where I got 185, 220 and 177. I was concerned and went to a clinic who tested me twice again to get insurance coverage, which needs two sub 300 results. Turns out my last two tests were at around 320.
Its low but within the “normal range” so insurance won’t cover. Cost isnt an issue for me, my bigger concern is getting TRT with “normal” levels.
My life is going pretty well, have kids, a successful career, muscular etc, but Ive struggled with fatigue for years. I’m having a hard time deciding. Thoughts? What would you do?
Edit: today is 6/1 and 3 hours ago I got my first shots: 150mg T and HCG. Wish me luck. The placebo effect (or is it?) is kicking in hard. Mood lifted and feeling vibrant probably because I got over the psychological barrier and made a decision after mulling on its for 24 hours. I went to a local clinic but think I will change to TRT Nation to save money.

Hi all,
Looking for a little advice! I’m a PA heavy gunner and I’m almost finished assembling my T-65 set. I have one of basically every heavy gun around, excepting perhaps some unique ones. I play full health, mostly non-VATS, and carry a whole armory as I trundle through the wasteland like a freight train. Most of my guns are AA and I only recently came back to the game, so i don’t have much coherence in my PA legendary effects (they are new to me). I’ve got 5/6 legendary perk slots, using Strength, Energy Absorb, What Rads, Funky Duds, and Taking One for the Team (if that helps at all).
So here’s what I’d like to know y’all’s opinions on - what guns currently lootable in game (no legacy trading) are the best for the unstoppable juggernaut I’d like to be? Also, what legendary PA stars would you shoot for (only caveat is i don’t want to play bloodied/low health)?
A few of my favorite tools lately include: • AA / Explosive / 25% off VATS cost Gatling Gun for mobbing / tagging in events, and if I want to use VATS on tricky targets. • AA / + 25% while aiming - I have this as a Gatling Plasma and an Ultracite Gatling Laser for bosses or meatier enemies. • Juggernaut / +25% aiming Flamer for close range brawls. • AA minigun with no bullets and shredder for melee shenanigans.
I also have a Plasma Caster and a Gauss Minigun but I haven’t rolled real legendary stars on them yet. Also got a Final Word (which I love but can’t keep ammo stocked) and a Peacemaker (that I want to use but likely needs its own loadout for explosive perks). Hell, I even carry an AA LMG but that magazine is so small.
SO, what am I missing? What would you recommend? Please advise, I’m not really up to date on any meta stuff since I last played in 2021 😅

Hello everyone and welcome to our new members,
As mentioned yesterday, we hope everyone had a great and safe long weekend. We have a strong conviction on this one. The tech appears solid and the need for these systems is on the rise.
Your Coming Summer of Blackouts The grid monitors say two-thirds of the U.S. risks electricity outage. -WSJ
US power grids vulnerable to extreme heat conditions this summer, NERC says -Reuters
Next Gen Battery Storage and Solar Power for Industrial and Residential Use
NeoVolta Inc. (NASDAQ: NEOV) Poised to Take Advantage of Government Incentives, Impressive Management and Experiencing Rapid Growth
Current Price $2.80/Share Public Float 28.28M Shares Held by Insiders and Institutions 18.07% - Source Yahoo Finance
About NeoVolta - NeoVolta designs, develops, and manufactures advanced energy storage systems for both residential and industrial use. Its storage solutions are engineered with lithium iron phosphate (LiFe(PO4)) battery chemistry, which is clean, nontoxic, and nonflammable. The residential-focused NeoVolta NV14 is equipped with a solar-rechargeable 14.4 kWh battery system, a 7,680-Watt inverter, and a web-based energy management system with 24/7 monitoring. The system’s 6,000-cycle battery life, one of the longest on the market, translates to 16.5 years of useful life, based on a full charge and discharge each day. The NV14 has passed the product safety standards set forth by Underwriters Laboratories (UL) for battery energy storage safety testing.
Award Winning Technology
The NV14 system has been named one of Solar Power World’s Top Solar Storage Products for 2022. This marks the fourth consecutive year the NV14 has received the award from Solar Power World, one of the solar industry’s leading media outlets.
How it Works
Engineered For Safety With Iron, Not Ion Home Energy Storage Built with Safer Lithium Iron Phosphate Built with Lithium Iron Phosphate [LiFe(PO4)] Longer-lasting and safer battery technology
Non-toxic, cobalt-free energy storage Built for Stability Non-toxic, with superior thermal and chemical stability
NeoVolta Is Built with Safer Lithium Iron not Lithium Ion with Cobalt Built specifically for solar energy storage Batteries are designed for homes, not for cars
NV14 has a higher temperature tolerance than Lithium-Ion batteries Under extreme heat, Iron outperforms Ion
No Maintenance Costs Required 10 year warranty
Built with longer-lasting IRON, not ION 13,896 Wh X 365 days x 10 years 50,720 kWh lifetime throughput
Floor or Wall Mounted Easy Installation Weatherproof and installs in a garage or on the side of a home.
Remote Monitoring They monitor the health of the system so you don't have to.
VIDEO: See How the NeoVolta NV14/NV24 Work
NeoVolta’s NV14 is the first Lithium Iron Energy Storage System to be approved by the California Energy Commission. It seamlessly powers up to 16 breakers and 32 amps of continuous power through peak rates or grid outages.
Connect to DC solar installations without any external inverters or to AC solar installations via String or Micro Inverter.
The rapid auto transfer switch, ensures that even when the grid goes down, power remains uninterrupted.
Recent News
NeoVolta’s Backup System Saves MDX Labs’ Lifesaving Medications During Multiple Grid Outages
- Commercial Battery Backup System Has Prevented the Loss of MDX’s Critical Functions and Thousands of Dollars in Inventory During Numerous Power Failures
SAN DIEGO, May 09, 2023 (GLOBE NEWSWIRE) -- NeoVolta Inc. (NASDAQ: NEOV) – NeoVolta Inc., manufacturer of Smart Energy Storage Solutions, has kept MDX Labs protected during multiple grid outages with reliable battery backup. Thanks to NeoVolta, the laboratory’s critical functions (refrigeration, server, and lights) have kept running, saving thousands of dollars while sustaining lifesaving medications and vaccines.
Founded in 2020, Henderson-based MDX Labs is the top privately held molecular and clinical diagnostic laboratory in the state of Nevada. MDX provides on-site testing services to a range of manufacturers, casinos, entertainers, restaurants, and nonprofit organizations, and it is the official overflow laboratory for the Southern Nevada Health District.
MDX Labs houses large quantities of vaccines, patient samples, and medications that require refrigeration. When grid outages occurred in the past, MDX would often lose tens of thousands of dollars in product and face periods of product unavailability while awaiting restock. In late 2021, MDX began searching for a battery backup system and discovered NeoVolta, which features a clean lithium iron phosphate battery and a hybrid inverter that can accept 208-volt power connections. NeoVolta can also charge from the power grid, eliminating the need for solar installation. In March 2022, MDX Labs installed NeoVolta’s NV14 Energy Storage System.
“Being able to support commercial facilities that are powered with 208-volt electricity is an amazing capability. Transformers are not required, which saves customers thousands of dollars and eliminates loud equipment that gives off radiant heat,” said Brent Willson, CEO of NeoVolta. “Our energy storage solutions are a very smart investment, especially considering the cost and consequence of an outage that would result in the loss of vital medical supplies and medications. We are thrilled to be partnering with MDX, a world-class clinical diagnostic laboratory.” FULL ARTICLE
NeoVolta Approved for Partnership by GoodLeap, the Top U.S. Financer for Solar and Sustainable Tech
- Offering Flexible Options for Consumers to Pay for Battery Storage
- NeoVolta Approved for Partnership by GoodLeap, the Top U.S. Financer for Solar and Sustainable Tech
SAN DIEGO, May 04, 2023 (GLOBE NEWSWIRE) -- NeoVolta Inc. (NASDAQ: NEOV) – NeoVolta Inc., manufacturer of Smart Energy Storage Solutions, has partnered with the sustainable home improvement finance platform GoodLeap to make solar energy storage as affordable as possible for more homeowners.
GoodLeap will finance standalone NeoVolta Energy Storage System (ESS) installations with or without solar panels. They offer flexible terms and highly competitive rates. As of 2022, GoodLeap was the number one financing platform, responsible for 26% of the entire U.S. residential solar market.
To apply, homeowners can coordinate with their installer on costs and then complete an online application. The process is fast and easy, and the underwriting is very flexible so that more homeowners get approved. Finally, GoodLeap has a strong reputation for exceptional customer service, with phone calls answered live by experienced solar professionals.
“GoodLeap’s low financing rates will allow more homeowners to enjoy years of utility savings and long-lasting blackout protection with NeoVolta energy storage,” said CEO Brent Willson, CEO of NeoVolta. “Our energy storage solutions are a very smart investment, and it’s never been easier to get started. With GoodLeap financing, NeoVolta’s market is opening to a much bigger audience. We are thrilled to be partnering with a world-class provider of sustainable home improvement financing.”
The partnership with GoodLeap is expected to help fuel NeoVolta’s continued success in the rapidly growing home energy storage market.
Devastating power outages throughout the country, caused by wildfires, extreme weather, and an increasingly unstable grid system, have underscored the urgent need for home backup power.
NeoVolta storage systems are designed for safety and performance. They use lithium iron phosphate battery chemistry, the nonflammable and nontoxic alternative to lithium ion. NeoVolta’s flagship NV14 energy storage system has a very high storage capacity of 14.4 kilowatt-hours, expandable to 24.0 kWh with the optional NV24 battery—without the expense of a second inverter. The system’s inverter discharges 7.7 kilowatts of instantaneous power, more than most mainstream competitors.
For its superior safety, performance and compatibility with any solar system, new or existing, the NV14 has been named one of Solar Power World’s top storage products four years in a row. FULL ARTICLE
NeoVolta Selected to Provide American Development Partners with Energy Storage for More Than 400 Regenerative Treatment Centers
- NeoVolta’s Energy Storage and Intelligent Power Management Will Be Deployed in Treatment Center Builds Nationwide Over Next Seven Years
- NeoVolta Selected to Provide American Development Partners with Energy Storage for More Than 400 Regenerative Treatment Centers
SAN DIEGO, March 14, 2023 (GLOBE NEWSWIRE) -- NeoVolta Inc. (NASDAQ: NEOV) – NeoVolta Inc., manufacturer of Smart Energy Storage Solutions, announced today that its systems will be deployed in more than 400 Orthagenex treatment centers nationwide. This is part of a rollout of NeoVolta batteries in thousands of American Development Partners (ADP) properties across the country over the next several years.
Together with ADP, NeoVolta will provide energy storage systems and intelligent power management for Orthagenex’s cutting edge regenerative medicine treatments centers. These 400 builds over the next seven years will be equipped with NeoVolta’s NV14 and NV24 Energy Storage Systems. The clean solar energy stored in the NeoVolta batteries will be used to dramatically reduce electric bills and serve as a backup in the event of a power loss.
American Development Partners developer Manny Butera said, “At ADP, we work with companies who innovate. NeoVolta’s advanced energy storage product is a perfect fit for the properties we are developing. We are thrilled to continue our close relationship with NeoVolta.” FULL ARTICLE
NeoVolta Poised for California’s NEM Incentives to Pair Solar with Battery Storage
- Additional $630 Million in California State Funding Set Aside to Support Residential Low-Income Solar Plus Storage Adopters
- NeoVolta Poised for California’s NEM Incentives to Pair Solar with Battery Storage
SAN DIEGO, Jan. 26, 2023 (GLOBE NEWSWIRE) -- NeoVolta Inc. (NASDAQ: NEOV) – NeoVolta Inc., manufacturer of Smart Energy Storage Solutions, announced today that it expects California’s recently updated Net Energy Metering (NEM) program to drive increased demand for energy storage systems.
On December 15, 2022, the California Public Utilities Commission (CPUC) issued a decision to update the NEM tariff to promote consumer adoption of solar and battery storage. The program will go into effect on April 13, 2023. According to the CPUC, the move was designed to financially incentivize Californians to install both battery and solar systems.
The CPUC stated that the current NEM 2.0 program was not aligned with California’s grid reliability and climate goals, noting that the increased use of electricity between 4 and 9 p.m. causes dependence on fossil fuel gas plants to meet the demand. With the battery storage incentive, the CPUC hopes to see an increased adoption of residential energy storage that will better support the needs of the grid, with customers saving self-generated solar energy for use in the evening hours.
An additional $630 million in state funding has been set aside by the California State Legislature for residential low-income solar plus battery storage adopters. The decision bolsters federal incentives provided by the Inflation Reduction Act for solar and battery storage.
It’s important to note that NEM 3.0 is not retroactive. Rooftop solar systems installed under NEM 2.0 will remain under that policy for a 20-year grandfathering period. This means existing rooftop solar owners who add a battery after the April 13 deadline will not be subject to NEM 3.0.
“We expect that NEM 3.0 will make Californians more aware of their energy consumption, encouraging them to conserve energy and pair rooftop solar systems with battery storage,” said NeoVolta CEO Brent Willson. “Californians who adopt this strategy will dramatically reduce their electrical bills while increasing their energy resiliency during periods of prolonged blackouts, fires, and flooding.”
California’s vast solar plus storage market has a dramatic impact on the grid. California has about 12 GW of distributed solar generation already installed, equal to nearly 25% of peak demand statewide. California also has more than 80,000 customer-owned batteries connected to the grid, with a storage potential of 900 MW, according to a September 2022 study by the California Solar & Storage Association. FULL ARTICLE
Homebuilder Rebates and Savings
Starting 2020: California Requires Solar On New Construction Each NeoVolta NV14 Could Save Builders $8,500+ (Equipment & Rebates)
Impressive Management
Brent Wilson, CEO
Brent Willson is a retired USMC Colonel with 30+ years of experience, who managed $100B aviation acquisition portfolio for the Defense Department. Brent is passionate about clean energy and providing battery energy storage solutions to consumers that provide the comfort of black out protection and the ability to offset increasing grid costs, with the solar power they produce.
NeoVolta Directors & NeoVolta Advisory
An older investor presentation (2019) but still relevant.
We will be back with more soon on NeoVolta Inc. (NASDAQ: NEOV)
The Team